endo Flashcards
Tanner stage 1
no hair
girls: raised nipple
tanner stage 2
pubic hair appears
girls: breast bud
boys: testis enlargement
tanner stage 3
pubic hair coarsening (not on thigh)
girls: breasts start mounding
boys: penis ↑
Tanner stage 4
pubic hair not on thigh
girls: breasts are mound on mound
boys: penis ↑
Tanner stage 5
pubic hair on thigh
adult tanner
When can you cross percentile lines without concern?
infancy
puberty
Pediatric Hypothyroidism most likely cause?
Hashimoto
How to test:
type 1 vs type 2 DM
auto-islet antibodies
HCM murmur
S4, systolic murmur
can have mitral regurgitation
asymmetric septal hypertrophy and systolic anterior motion of mitral valve–> outflow obstruction –> dyspnea, possible syncope.
What is S4
S4—in late diastole (“atrial kick”)
↑ atrial pressure- Associated with ventricular noncompliance (eg, hypertrophy)
Left atrium must push against stiff LV wall
Best heard at apex with patient in left lateral decubitus
position
Consider abnormal, regardless of age
What is S3
S3—in early diastole during rapid ventricular
filling phase.
Associated with ↑ filling pressures (eg, mitral regurgitation, HF)
more common in dilated ventricles
can be normal in children and young adults
S1 vs S2
S1—mitral and tricuspid valve closure. Loudest
at mitral area.
S2—aortic and pulmonary valve closure.
Loudest at left upper sternal border.
S2 is?
S2—aortic and pulmonary valve closure.
Loudest at left upper sternal border.
S1 is?
S1—mitral and tricuspid valve closure. Loudest at mitral area.
a reentrant tachycardia with abrupt onset and termination
Wolff-Parkinson-White
Concussion grades
1- (mild) concussions, no,LOC, return to baseline in 15 min
2- moderate concussions, no LOC, return to baseline > 15 min
3- sever concussion, has LOC
contraindications to sports participation
one eye, hemophilia, single kidney, and unexplained syncope
Prehn sign
elicited by lifting the scrotum toward the symphysis.
Pain relief = epididymitis
Pain worse= torsion
Inguinal adenopathy that suppurates and causes chronic draining of sinuses is commonly seen in chancroid
Haemophilus ducreyi
Gaucher disease is characterized by __________ deficiency
Gaucher= β-glucocerebrosidase deficiency
Bone marrow aspirate shows the Gaucher cells engorged w/ glucocerebroside
Niemann-Pick disease deficiency
Sphingomyelinase deficiency
Erlenmeyer-flask appearance of the long bones
Gaucher disease
Neonatal thyrotoxicosis exposure
- TSH does NOT cross the placenta
- maternally-acquired thyrotropin receptor-stimulating antibody (TRSAb) does (mom=graves)
Neonatal thyrotoxicosis s/s
tachycardia and tachypnea irritability /hyperactivity ↓ birth weight microcephaly severe NVD thrombocytopenia jaundice/hepatosplenomegaly heart failure
true precocious puberty
s/s: premature telarche, vaginal bleeding, pubic hair, body odor, and acne
most= idiopathic (GnRH tumor possible)
GnRH analogs= effective therapy.
Puberty is said to be delayed in males if physical changes are not apparent by __________
by 14 years of age- Puberty is said to be delayed in males if physical changes are not apparent
male pubertal development -penile length > 2.5 cm; testicular volume> 3.0 cm^3
Bone age in constitutionally short stature with delayed pubertal maturation?
Bone age =best test for constitutionally short stature with delayed pubertal maturation:
bone age=height age
* both of which are behind chronologic age.
Bone age in familial short stature?
bone age > height age
bone age= chronologic age.
Cardiac lesions are found in Down syndrome, including
- Endocardial cushion defect
- VSD
- Tetralogy of Fallot
- each occur ~ 30%
Cushing abnormality
The basic abnormality, however, is thought to be in the hypothalamic-pituitary axis, NOT the adrenal gland
These boy patients have many features in common with Turner syndrome
Noonan syndrome
*occurs in both genders
Other features=, pulmonary stenosis, edema hands /feet, hearing loss, pectus excavatum, and mental retardation
deficiency in Hurler
α-L-iduronidase deficiency
features: umbilical hernia, kyphoscoliosis, deafness,
cloudy corneas, and claw hand deformity. Death is common from resp depression
